DR. Carmen Luisa Mediavilla, M.D.

NPI #1407050776 in Hato Rey, Puerto Rico

Provider Information

NPI Number: 1407050776
Entity Type: Individual
Name: DR. Carmen Luisa Mediavilla, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Clinic/Center - Medically Fragile Infants and Children Day Care
Credential: M.D.
Enumeration Date: Jun 12, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 400 AVE. F.D. ROOSEVELT
Address 2: ,CLINICA LAS AMERICAS SUITE 203
City: Hato Rey
State: Puerto Rico
ZIP Code: 00918
Phone: (787) 783-4423

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Medically Fragile Infants and Children Day Care — Medically Fragile Infants and Children Day Care	261QM3000X	Primary

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